BMJ Best Practice

鉴别诊断

疾病
体征 / 症状
检查
体征/症状

Acute onset of swelling, warmth, redness, and pain that is more diffuse and can involve the whole leg. Palpable cord is not common along the course of an affected vein unless there is concomitant superficial vein thrombophlebitis (SVT).

检查

多普勒超声:深静脉系统血栓将明确诊断。

体征/症状

Erythema is usually localised and confluent, with associated tenderness and generalised swelling. There may be associated lymphangitis or tender lymphadenopathy, which is not characteristic of SVT. A palpable cord is not present with cellulitis. Systemic findings of fever, chill, and myalgias are more common with cellulitis.

检查

多普勒超声:可压迫的血管,没有浅表静脉血栓。

体征/症状

通常非急性,而是慢性、非凹陷性肢体水肿,并累及手指/足趾。休息后水肿无改善。

检查

多普勒超声:可压迫的血管,没有浅表静脉血栓;B超成像显示皮下水肿。

体征/症状

慢性腿部肿胀,伴有相应区域静脉扩张、静脉曲张和皮肤变化(包括脂膜炎、色素沉着过度、瘀滞性皮炎、脂性硬皮病和静脉溃疡)。

检查

诊断常常依靠临床检查。

多普勒超声可明确诊断:可以显示瓣膜功能不全和慢性静脉阻塞。

体征/症状

脂膜炎最常见的表现通常包括进展性双侧疼痛性皮损,常位于小腿。没有可触及的条索状物。

检查

病理活检:间隔性脂膜炎。

体征/症状

血管炎的一种类型,由沿动脉分布的亮红色到蓝色的结节组成。通常形成双侧、皮下融合的疼痛斑块。

检查

皮肤活检:动脉坏死性血管炎。

体征/症状

A recent history of an insect bite or sting is typically given. Swelling and redness usually extend over a large area and do not follow the course of a vein. There may be associated pruritus.

检查

诊断常常依靠临床检查。

多普勒超声:浅表静脉血栓为阴性。

体征/症状

Usually pain, mild swelling, and warmth in the area of a tendon (e.g., Achilles', patellar). Pain increases with movement of affected joint, and a tendon friction rub may be palpable. Pain is worse during and after activity, and the tendon and joint area can become stiff as the swelling impinges on the movement of the joint.

检查

超声:增厚、模糊的肌腱和腱内低回声灶。

核磁共振:肌腱损伤。

淋巴管炎

体征/症状

感染灶(例如,蜂窝织炎)近侧皮肤沿淋巴管走向可见红斑、热、痛,一直延伸至所属淋巴结。通常可触及肿大淋巴结。

检查

多普勒超声:可压迫的血管,没有浅表静脉血栓。

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